Safe transportation of infants, both preterm and term, with the use of car seats and car beds is essential. Car seats and car beds prevent injury and death according to the National Highway Traffic and Safety Administration. However, previous studies have shown some respiratory compromise occurs in preterm infants placed in car seats. It has now been demonstrated in a study by L. Cerar from Pediatrics August 2009 that the same might be true of full term infants.
Two hundred newborns were evaluated on the second day of life by measuring oxygen levels and breathing patterns in car seats, car beds, and cribs. The same infants measured in each of the devices also served as their own controls. It was found that oxygen levels were significantly lower in both car seats and car beds compared to hospital cribs. In addition, even those infants that were able to compensate for the respiratory limitations initially were found to develop respiratory compromise with prolonged periods of time due to deeper sleep stages and more chest wall muscle fatigue.
The reasoning behind the findings is that there is some obstruction to the airway due to flexion of the head when an infant is placed in the car seat or car bed causing these lower oxygen levels. The other important factor is some compromise of the chest wall motion that occurs in the upright position even though the safety belt was standardized to allow for 1 finger width distance between the infant and the harness.
The conclusion from this important study is that parents should only use car seats and car beds for travel and not as a replacement for a crib. Infants should not be placed in these transport safety devices for prolonged periods of time. Finally, manufacturing companies should brainstorm on how to redesign these devices to eliminate the respiratory compromise that occurs when infants are placed in the upright position with flexion of the head for prolonged periods of time. Most pediatric specialists do not feel that the implications of this compromise is significant in the long run but others feel that even a mild amount of obstruction might be associated with behavioral problems and IQ deficits.